DEPARTMENT OF
PUBLIC WELFAREEstablishment of an Additional Class of Disproportionate Share Payments [35 Pa.B. 6387] This notice announces the Department of Public Welfare's (Department) intent to establish an additional class of disproportionate share payments for certain qualifying hospitals.
The Department intends to make this payment, in addition to the classes of disproportionate share payments already made under the Medical Assistance (MA) Program, to certain qualifying general acute care hospitals with excluded psychiatric units, which the Department has determined provide a high volume of services to the MA eligible population in this Commonwealth, including a high volume of psychiatric inpatient services, and incur significant uncompensated care costs. This payment is intended to assure the hospitals' continued participation in the MA Program.
The Department intends to consider a hospital eligible for this additional class of disproportionate share payments if the hospital meets all of the following criteria, based on the Fiscal Year (FY) 2002-2003 MA Cost Report, unless specified otherwise:
a) The hospital is enrolled in the MA Program as a general acute care hospital with an excluded psychiatric unit.
b) The hospital provides MA inpatient days of care in excess of the 85th percentile of MA inpatient days provided by all enrolled general acute care hospitals with an excluded psychiatric unit.
c) The hospital's number of MA admissions exceeds the 85th percentile of MA admissions of all enrolled general acute care hospitals with an excluded psychiatric unit.
d) The hospital provides inpatient psychiatric days of care to MA recipients in this Commonwealth in excess of the 90th percentile of these days provided by all enrolled acute care hospitals with an excluded psychiatric unit.
e) The hospital's percentage of uncompensated care to net patient revenue exceeds the 90th percentile of this percentage for all enrolled acute care hospitals with an excluded psychiatric unit based on the Pennsylvania Health Care Cost Containment Council (PHC4) Financial Analysis 2004.
f) The hospital's operating margin is less than the 15th percentile of the operating margins of all enrolled acute care hospitals with an excluded psychiatric unit based on PHC4 Financial Analysis 2004.
The Department intends to allocate funds from the State General Fund for this additional class of payments. The Department will divide payments proportionately between qualifying hospitals based on the percentage of each qualifying hospital's MA inpatient days to total MA inpatient days of all qualifying facilities. Payment limitations are still applicable, including those limitations that the Commonwealth may not exceed its aggregate annual disproportionate share allotment and that no hospital may receive disproportionate share payments in excess of its hospital-specific limit.
Fiscal Impact
The FY 2005-2006 fiscal impact, as a result of this disproportionate share payments, is estimated at $2.225 million ($1 million in State funds).
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be viewed and considered for any subsequent revision of this notice. Persons with a disability who require an auxiliary aid or service may submit comments using the AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-446. (1) General Fund; (2) Implementing year 2005-06 is $1 million; (3) 1st Succeeding Year 2006-07 is $1 million; 2nd Succeeding Year 2007-08 is $1 million; 3rd Succeeding Year 2008-09 is $1 million; 4th Succeeding Year 2009-10 is $1 million; 5th Succeeding Year 2010-11 is $1 million; (4) 2004-05 Program--$531.785 million; 2003-04 Program--$411.042 million; 2002-03 Program--$407.104 million; (7) Medical Assistance--Inpatient; (8) recommends adoption. Funds have been included in the Department's budget to cover this increase.
[Pa.B. Doc. No. 05-2136. Filed for public inspection November 18, 2005, 9:00 a.m.]
